HEALTH INSURANCE FOR PSYCHOLOGY

Psychology sessions can be funded through three separate channels. Understanding which applies when — and how to combine them — maximises your subsidised sessions per year.

Pathway 1: Medicare — Mental Health Treatment Plan (MHTP)

Factor	Detail
Sessions per year	Up to 10 individual sessions per calendar year
How to access	GP creates a Mental Health Treatment Plan (MHTP)
Medicare rebate (clinical psychologist)	{{MEDICARE_CLINICAL_PSYCH_REBATE}}/session
Medicare rebate (general psychologist)	{{MEDICARE_GENERAL_PSYCH_REBATE}}/session
Typical session fee	{{PSYCH_SESSION_FEE_RANGE}}
Your gap (clinical psychologist)	{{MEDICARE_CLINICAL_PSYCH_GAP}}/session
Your gap (general psychologist)	{{MEDICARE_GENERAL_PSYCH_GAP}}/session
Bulk-billed sessions (if psychologist bulk-bills)	$0 — but availability is limited
Waiting period	None — Medicare entitlement
Referral required	Yes — GP must create MHTP first
Review required	GP review after 6 sessions to authorise remaining 4

How the MHTP works:

1. See your GP and discuss your mental health concerns
2. GP creates a Mental Health Treatment Plan (takes approximately 20-40 minutes — a longer appointment)
3. GP provides a referral to a psychologist (you can nominate a specific psychologist)
4. You book sessions with the psychologist — first 6 sessions authorised
5. After 6 sessions, return to your GP for a review — remaining 4 sessions authorised
6. 10 sessions total per calendar year — resets 1 January

Pathway 2: Extras insurance — psychology benefits

Factor	Basic Extras	Mid Extras	Top Extras
Psychology rebate per session	{{BASIC_PSYCH_REBATE}}/session	{{MID_PSYCH_REBATE}}/session	{{TOP_PSYCH_REBATE}}/session
Annual psychology limit	{{BASIC_PSYCH_LIMIT}}	{{MID_PSYCH_LIMIT}}	{{TOP_PSYCH_LIMIT}}
Estimated sessions covered	{{BASIC_PSYCH_SESSIONS_EST}}	{{MID_PSYCH_SESSIONS_EST}}	{{TOP_PSYCH_SESSIONS_EST}}
Waiting period	2 months	2 months	2 months
Referral required	No — see any registered psychologist	No	No
Claiming method	HICAPS, app, or online	Same	Same

Key difference from Medicare: Extras psychology doesn't require a GP referral or MHTP. You can see any registered psychologist and claim directly. This makes extras useful for people who want to access psychology without going through the GP referral process, or who have used their 10 Medicare sessions and need more.

Pathway 3: Hospital insurance — inpatient psychiatric only

Hospital insurance covers psychology only during an inpatient psychiatric admission — when you're admitted to a psychiatric hospital or ward for intensive treatment. This is covered on all hospital tiers including Basic with a 2-month waiting period.

Hospital-based psychology during an inpatient stay is part of the treatment program — daily individual and group therapy sessions delivered by the facility's psychology team. You don't choose your own psychologist during inpatient stays. This pathway is for acute or severe mental health episodes, not regular outpatient psychology.

You cannot claim both Medicare and extras on the same session — it's one or the other per appointment. But you can use both sources across different sessions within the same year to extend your total subsidised sessions.

Strategy 1: Medicare first, extras second

Sessions	Source	Your gap per session
Sessions 1-10	Medicare MHTP	{{MEDICARE_CLINICAL_PSYCH_GAP}}
Sessions 11-20+	Extras insurance	{{EXTRAS_PSYCH_GAP_MID}}

Use your 10 Medicare sessions first (higher rebate for clinical psychologists), then switch to extras for additional sessions beyond the Medicare allocation. This maximises your total subsidised sessions — up to 10 Medicare + {{MID_PSYCH_SESSIONS_EST}} extras = approximately {{TOTAL_COMBINED_SESSIONS}} subsidised sessions per year on Mid extras.

Strategy 2: Extras only (no GP referral)

If you don't want to involve your GP or create an MHTP, use extras exclusively. No referral needed — book directly with any registered psychologist. Your annual limit ({{MID_PSYCH_LIMIT}} on Mid extras) determines how many sessions you can claim.

Strategy 3: Alternating sources

Some people alternate: Medicare for one session, extras for the next. This extends each pool further. However, most psychologists and insurers prefer consistency within a claim pathway — discuss with your psychologist which approach they recommend for billing simplicity.

The type of psychologist you see affects both the Medicare rebate and the type of treatment you receive.

Factor	Clinical Psychologist	General (Registered) Psychologist
Qualifications	Masters or Doctorate in Clinical Psychology + area endorsement	4-6 year psychology degree + supervised practice
Medicare rebate	{{MEDICARE_CLINICAL_PSYCH_REBATE}} (higher)	{{MEDICARE_GENERAL_PSYCH_REBATE}} (lower)
Typical session fee	{{PSYCH_SESSION_FEE_CLINICAL}}	{{PSYCH_SESSION_FEE_GENERAL}}
Typical gap (Medicare)	{{MEDICARE_CLINICAL_PSYCH_GAP}}	{{MEDICARE_GENERAL_PSYCH_GAP}}
Extras rebate	Same (extras don't distinguish)	Same
Specialisation	Complex presentations — trauma, personality disorders, psychosis	General mental health — anxiety, depression, adjustment, relationships
Availability	Fewer, often longer wait for new patients	More available, shorter wait

Which should you see? For most common presentations (anxiety, depression, stress, adjustment difficulties, relationship issues), a general psychologist provides effective treatment. Clinical psychologists are recommended for complex or severe presentations, trauma, personality disorders, or where specialist expertise is needed. Your GP can advise on which type is appropriate for your situation.

The Medicare rebate for clinical psychologists is higher — but their fees are also typically higher, meaning the gap may be similar. Compare the actual gap (fee minus rebate) rather than just the rebate amount.

Finding a Medicare-rebated psychologist:

• Ask your GP for recommendations when creating your MHTP
• Search the APS (Australian Psychological Society) "Find a Psychologist" directory — filter by location, specialty, and whether they accept Medicare referrals
• Call clinics directly and ask whether they accept MHTP referrals and their current waiting time

Finding a psychologist for extras claiming:

• Use your insurer's "Find a Provider" tool — filter by psychology and your location
• Check for preferred providers who may offer higher rebates or no-gap sessions
• HICAPS-enabled practices allow instant claiming

Waiting times for new patients: Psychology has significant demand across Australia. Waiting times for new patients range from {{PSYCH_NEW_PATIENT_WAIT_RANGE}} depending on location and type of psychologist. Rural and regional areas typically have longer waits. If the wait is too long, consider:

• Telehealth psychology (broader provider pool, no geographic limitation)
• Provisional psychologists (supervised practitioners with lower fees)
• University psychology clinics (lower-cost sessions with supervised postgraduate students)

Telehealth (video call) psychology sessions have become widely available and are covered by both Medicare and most extras policies.

Factor	Detail
Medicare coverage	✅ MHTP sessions can be delivered via telehealth — same rebate as in-person
Extras coverage	⚠️ Most insurers cover telehealth — check your policy. Some require in-person for first session.
Session quality	Research shows comparable outcomes for most conditions via telehealth
Advantages	No travel, broader provider access (not limited to local area), flexible scheduling
Limitations	Not suitable for all presentations (severe crisis, young children may need in-person), requires stable internet

Telehealth expands your options significantly — particularly if local psychologists have long waiting lists. You can see a psychologist in another city or state via video call and claim the same Medicare rebate or extras benefit.